Philosophy for Life - official website of author Jules Evans » Big Pharmahttp://philosophyforlife.org
Sun, 29 Mar 2015 11:43:32 +0000en-UShourly1http://wordpress.org/?v=4.1.1Where next for well-being policy?http://philosophyforlife.org/where-next-for-well-being-policy/
http://philosophyforlife.org/where-next-for-well-being-policy/#commentsFri, 11 Apr 2014 13:57:55 +0000http://philosophyforlife.org/?p=5033I went to the book-launch of a new book on well-being policy yesterday, which brought together some leading figures in this nascent movement – including David Halpern of the government’s ‘nudge unit’, Canadian economist John Helliwell, psychologist Maurren O’Hara, and Juliet Michaelson of the new economics foundation. The book – Well-being and Beyond – is Read more...

]]>I went to the book-launch of a new book on well-being policy yesterday, which brought together some leading figures in this nascent movement – including David Halpern of the government’s ‘nudge unit’, Canadian economist John Helliwell, psychologist Maurren O’Hara, and Juliet Michaelson of the new economics foundation. The book – Well-being and Beyond – is edited by Michaelson and Timo Hamalainen, and has some great essays in it, including a particularly interesting one by Mihayli Csikszentmihalyi on ‘the politics of consciousness’.

With the news that the government is set to establish a What Works research centre for evidence-based well-being policy, and that David Cameron may be resuscitating his well-being agenda, it seems like a good time to take a panoramic view of the politics of well-being in the UK, some of the areas into which it’s developing, and some of the areas where more research is needed. It will obviously be a partial and incomplete view, but here goes:

Schools

The ministry of education under Michael Gove pulled back on some of New Labour’s well-being initiatives, such as Every Child Matters and the promotion of Social and Emotional Aspects of Learning (SEAL). However, there seems renewed political interest in the idea of teaching character skills like resilience, with all three parties recently offering broad support for such a move. The work of James Heckman, focused on early interventions, is particularly popular with policy-makers at the moment.

The area is likely to progress through local and regional evidence-based initiatives, rather than top-down national initiatives like SEAL. Key players include the Jubilee Centre for Character and Values, Jen Lexmond’s work at Character Counts and elsewhere, James O’Shaughnessy’s Positive Education network, the Education Endowment Fund’s research, and the National Citizen Service, which apparently is building up a great evidence base for its intervention. The challenge is how to teach not just skills but also values within a pluralistic and multicultural society – more on this below.

Work

There’s growing interest in the importance of well-being at work, partly driven by the high economic cost of sick days due to stress and mental illness. Some of the more enlightened companies have bespoke well-being courses for their staff – like Google, Zappos, M&S, British Telecom or Saracens rugby club – in a manner reminiscent of 19th century Quaker companies like Rowntree’s. A key player in this area is the firm Robertson Cooper, which established the Good Day at Work network.

Nils Mordt of Saracens brushing up on some philosophy

As in schools, the new focus on work well-being ties in – or should tie in – with an ethical focus on values, character strengths and social responsibility. Saracens’ personal development course is a good example of how to teach well-being + values but in a flexible and peer-led way, compared to Zappo’s which, from the outside, seems quite inflexible and even authoritarian in its collective happiness ethos. Well-being at work ties in to another policy area, adult education (of which more below) – see, for example, Google’s emphasis on adult education for its workers, again reminiscent of Quaker companies like Rowntree’s. I also love the Escape the City network (by the by!).

That means greater support for the burgeoning Improving Access for Psychological Therapies programme across the UK, particularly in Wales, where there are high levels of depression and long waiting lists for talking therapy. It also means public health organizations like Public Health England taking more of a lead in promoting mental well-being. It means more support for peer-led well-being networks (one of the themes of Michaelson’s chapter in her book), which can draw inspiration from historical models like 19th century Friendly Societies. And it also means trying to work out a better way to treat psychosis, as the government is now trying to do.

Well-being health policy ties into well-being policy in other areas, particularly schools, work, and adult / online education. Empowering people to take care of their own physical and mental health means treating them as reasoning agents rather than as malfunctioning machines.

Prisons and probation services

At the book launch yesterday, John Helliwell mentioned a paper he’d written on well-being in prisons, championing the Singapore Prison Services’ reforms. Singapore pioneered a mutual model of well-being, in which staff, inmates, former inmates and the wider community worked together to help inmates flourish.

We’re a long way from that here, but there is some interest in the ‘desistance’ model of rehabilitation, whereby inmates make a reasoned choice to leave their former criminal life and to pursue a new narrative. This fits with the coherence model of well-being, in which well-being is connected to our ability to find meaning and value in ourselves and the world. Some charities and probation organizations are also looking to extend the desistance / mutuality model beyond the prison walls – I’m meeting with one such organization, Co:Here, next week.

In England, the probation system is on the verge of a massive privatization, which is likely to cause stress to the system and to the people in it. However, the chaos will also create opportunities for new and innovative approaches. I’m interested to learn more about the RSA’s research on prison learning.

The economy / housing / urban planning

The O’Donnell report suggests the best economic policies to promote well-being would be to reduce unemployment, which has a particularly negative impact on well-being. Fine – but which government says it’s in favour of high unemployment? Other well-being economists suggest there is a correlation between income equality and national happiness – but so far this has failed to lead to major tax distribution policies, and inequality continues to rise.

The UK housing bubble also continues to grow, with the average property price in London now approaching half a million pounds. This is likely to have a significant impact on people’s well-being, and their ability to feel in control of their destinies. As more and more humans live in ‘mega-cities’, will we know and trust our neighbours, will we have access to green spaces, will we have any real connection to nature?

More research needs to be done on the rise of solo living, which is particularly popular in Scandinavian countries (typically championed as happiness templates). What is the trade-off between autonomy and loneliness? Is solo living sustainable or equitable? Are new forms of conviviality emerging? The Joseph Rowntree Foundation has done good work in this area.

Adult education / online learning

So far there is little policy focus on the importance of adult education to well-being. Adult education is, in general, ‘off the radar for policy-makers’, as David Halpern put it. This makes no sense to me, considering all the research into the importance of coherence, meaning, reasoning and collective engagement to well-being – all of which points to adult education as a booster to well-being. There’s been some work showing that engaging in adult education predicts higher well-being, but that has not fed into policy discussions at all, sadly. The national budget for community education shrinks every year.

However, informal learning continues to grow, with various organizations appearing dedicated to raising well-being, including Action for Happiness and the School of Life. There have also been some encouraging developments in online well-being courses. Stanford’s Greater Good centre is launching an online happiness course in September, Berkeley has also launched a Positive Psychology MOOC, Action for Happiness recently launched an online course, while TED’s Understanding Happiness course has been in the top ten of iTunesU for a few years. Online learning connects to health policy in well-being, particularly with the rise of health apps.

It’s also worth mentioning the boom in mindfulness courses – including for example the phenomenal success of the book / CD ‘Mindfulness’, by Mark Williams and Danny Penman, which has been in the top 30 of Amazon for two years. Mindfulness is a policy intervention that can be deployed in health, work, education and prisons – similar in that respect to ‘mental resilience’ interventions.

Academia

British higher education seems so beleaguered that the well-being of staff and pupils is off the official agenda for the time being. If change comes, it is likely to be driven by students and staff rather than top-down, though perhaps some enlightened VC or chancellor will take the lead (eg Floella Benjamin at Exeter!) But this is a sector which potentially could play a very important role in the development and implementation of well-being interventions.

For example, universities could – and should – offer free courses in well-being to undergraduates. Such courses should (in my opinion) teach some of the techniques of well-being, such as meditation, gratitude, self-determination, resilience, while also providing a space for philosophical discussions about what it means to flourish. If done pluralistically, such courses would be an important space for inter-faith discussions, preventing campuses from becoming divided on religious lines.

I also think universities should do more to support the well-being of their staff, particularly PhDs, where burn-out and drop-out rates are high. Some PhDs, such as the LSE’s Inez von Weitershausen, are beginning to work on this, and I think funders like Wellcome are keen to support more work in this area.

Academia could also play an important role in promoting adult education, as it used to do in the university extension movement. Unfortunately, humanities academics seem to have little time for adult education work and little faith in well-being politics – which is typically dismissed as ‘neoliberal’. A few humanities academics, however, understand that well-being policy is an important way to champion the impact of the arts and humanities in national policy. The work of the Reader Organisation, based at Liverpool Uni, is a good example of this more enlightened and engaged approach (they have their national conference in London next month, by the by).

Sports / arts / the festive

Burning Man festival

Well-being research tells us how important sport and exercise is to our well-being. It’s also beginning to tell us about the importance of the arts to our flourishing, particularly arts that engage us collectively, such as singing in a choir or reading in a book club.

I’d like to see more research on the importance of ‘the festive’ to well-being – think of the work of Durkheim, Barbara Ehrenreich, Jonathan Haidt, Martha Nussbaum and Charles Taylor in this area – or Dan Ariely’s writing on Burning Man festival.

Why do the residents of the Orkneys have such high well-being? Ian Ritchie, former co-director of the St Magnus festival there, tells me that that one reason is the islands are so rich in festivals – a folk festival, a blues festival, a well-being festival. Parties, clearly, are good for us, particularly when we help to organize them. It would be good to study the well-being impact of starting a festival in a town. For example, Wigmore, a small town in Scotland with high unemployment, launched its own book festival two years ago and it seems to have revitalized that community.

More generally, well-being economists and psychologists need to connect with arts and humanities practitioners to explore the role of beauty, awe and wonder in well-being, and the higher states of consciousness which arts and ‘the festive’ can create. That means going beyond a aridly Benthamite notion of happiness towards a more Millsian appreciation of the transformative power of the arts.

The media

Alain de Botton has been generally mocked by humanities academics for his latest book, The News, but as is often the case there is wisdom beneath his gimmickry. Our well-being is deeply connected to our culture, and therefore to the media – in the broadest sense of TV, online media and advertizing. How, in a free market economy, can we try and make sure the messages we soak in are not entirely shallow?

This morning, it was announced that Richard Hoggart, the great public intellectual and critic of commercial television, has died. He thought commercial TV pushed viewers towards a way of life ‘whose texture is as little that of the good life as processed bread is like home-baked bread’. His involvement in the Pilkington Report led to the establishment of BBC 2. But the vision of Hoggart, Reith and others – that broadcasting could be a force for the raising of public consciousness – seems to be in abeyance.

Perhaps this area of policy links up with health and adult education – the BBC is looking to launch MOOCs on FutureLearn, and to develop its online learning platforms. I know people in BBC Arts have been interested in promoting things like meditation or ancient philosophy, but it hasn’t happened yet. Indeed, there is a weird absence of ethical / spiritual discussion on TV. Radio 2’s Sunday morning show, once a province of spiritual discussion, is now presented by a sports presenter, which sums up the BBC’s (understandable) unease with promoting any particular ethics in a multicultural society.

The environment

Clearly the big question for well-being policy is: is it at odds with the coming environmental catastrophe? Are we meditating while Rome burns?

In Well-Being and Beyond, Csikszentmihayli outlines three constituents needed for consciousness to flourish: first, the freedom to think what you want and decide what is true (rather than being coerced and lied to by our government); second, to find flow in meaningful and purposeful activity (he understands the importance of higher or altered states of consciousness like awe, wonder, transcendence and ecstasy). And finally, we need hope.

We need the hope, or faith, that tomorrow will be as good as if not better than today. That drives all of our activity, all our plans, our investment in our work and family. Without that, ‘consciousness becomes idle and atrophied’, or it shrivels up in despair or short-term hedonism.

What is weird and unnerving about this historical moment is the loss of hope. Living standards are declining, the young are poorer than the old, but above all, there is a collective sense that the future will be worse – perhaps much worse – than the present, that nature will be severely depleted, the world will be more crowded, politics will be more unstable, the weather will be more violent, and we may see mass migrations and perhaps mass extinctions of animals and humans. Indeed, the animal mass extinction has already begun.

Religion and Wisdom

This brings me to my final point, the final area of research which I think would be fruitful. I don’t think secular humanism is going to be sufficient to sustain us through the coming crisis, because its hope in progress and a better tomorrow will not last in the face of mass extinctions. You need something more transcendent to believe in and give you the strength to do the right thing and to take care of the weak, even in the face of mass extinction and social collapse. Techno-humanism – in which the rich get to detach or upgrade from the rest of humanity – seems to me a much, much worse option than a return to the wisdom of older religious traditions.

Religion seems to me the massive elephant in the room of well-being policy. Well-being policy practitioners sometimes seem to me like people who have had their cultural memories wiped, so that they need to re-discover the basics of human flourishing from scratch. ‘We’ve discovered volunteering is good for well-being! So is collective singing. So is a sense of meaning and purpose. So is gratitude. So are higher states of consciousness. So is neighbourliness, reciprocity and mutuality. So is self-control coupled with an acceptance of the limit of one’s control over the universe. So is faith in the future.’

Well…yeah. All of which we used to get from religion, before we trashed it and turned to psychologists for guidance.

How do we spread the wisdom of religious traditions in a multicultural and increasingly secular society? To me, the key word is wisdom. Wisdom gives us the ability to appreciate the insights and practices of multiple religious faiths, to have respect for those faiths and to learn from them, while also finding our home in a particular tradition.

We need to learn not just the techniques of ancient wisdom traditions (meditation, gratitude, self-control etc) but also to create the space to discuss the different moral ends or goals which those traditions promote – nirvana, union with God, happiness, inner peace, Aristotelian flourishing etc. These different ends should be discussed rather than forced upon people. Socratic discussion is a way to include these moral ends / values without imposing them on people.

At the heart of most of the ancient wisdom traditions is an optimism that humans can use our reason to take care of our souls and our societies, combined with an acceptance that our reason is bounded, and that flourishing emerges best through habits and shared practices. These wisdom traditions are therefore opposed to a more biomechanical model of humanity, which sees negative emotions as chemical imbalances to be corrected with medication.

We need universities to take wisdom seriously, but I actually think we need a new sort of research institute – closer to the Esalen model – which combines intellectual and experimental research with practice. Sort of a think-tank / monastery. As Alasdair MacIntyre says at the end of After Virtue: ‘We are waiting not for a Godot, but for another—doubtless very different—St. Benedict.”

Well, those are some areas of possible research. A lot to be getting on with! But this is an important movement, and the UK is blessed with some pioneering thinkers and practitioners in this field, not just in economics and psychology, but also in the arts, technology, philosophy and faith.

PS I forgot to mention mental health in the military services. But that’s obviously another potential area for interventions to promote resilience.

]]>http://philosophyforlife.org/where-next-for-well-being-policy/feed/11Beware toxic fatalism, in its atheist and theist formshttp://philosophyforlife.org/beware-toxic-fatalism-whether-atheist-or-theist/
http://philosophyforlife.org/beware-toxic-fatalism-whether-atheist-or-theist/#commentsFri, 15 Nov 2013 13:11:52 +0000http://philosophyforlife.org/?p=4557This week I met a charming young man who had recently dropped out of university. He was writing an undergraduate dissertation on free will, read Sam Harris’ book on the subject, and came to the conclusion that free will does not exist, therefore there was no point finishing his dissertation. So his university gave him Read more...

]]>This week I met a charming young man who had recently dropped out of university. He was writing an undergraduate dissertation on free will, read Sam Harris’ book on the subject, and came to the conclusion that free will does not exist, therefore there was no point finishing his dissertation. So his university gave him a ‘pass’ and he’s now wondering what to do next (not that he has any choice in the matter).

Talking to him, I was struck, paradoxically, by the power of ideas and beliefs to alter people’s lives, and to harm them. This smart young chap – call him Eric – happened to go to university now, in the high point of Scientistic Materialism, which meant he happened to have read Sam Harris, and to accept the hardcore materialist line that free will is an illusion. He accepted that idea, absorbed it into his organism, and it led to real-world consequences for him – he now can’t do an MA in anthropology, as he planned, and is stuck in something of an existential crisis.

Eric might say to me that what his situation really proves is that he had no choice. As I’ve just said, he happened to be at university during the high-point of Scientistic Materialism, he happened to be exposed to Sam Harris, and hence this situation. Yet I – like the good Stoic I am – would say that he did have a choice, whether to accept the hardcore materialist theory or not. He swallowed it, then he chose to act on it. And here’s where he ended up.

Nonetheless, his story does illustrate the power of culture – by which I mean the amniotic fluid of ideas that we find ourselves absorbing and feeding off. We may have some choice what we believe, but our range of choice is limited by the ideas we find in our culture at any one moment. And that is what worries me about the popularity of hardcore materialism in our culture – I think the theory that we have no free will is a toxic idea, which has serious real world implications for those unfortunate enough to swallow it, because it attacks and dissolves their sense of meaning, purpose and autonomy.

I don’t think the main battle line in our culture is between theists and atheists. The main dividing line, for me, is between those who believe in free will, and those who don’t. It’s between those who think we can use our conscious reason – however weak it is – to choose new beliefs and new directions in our life; and those who think we are entirely automatic machines, without the capacity to choose.

Hardcore materialists insist we don’t have free will, we don’t have the capacity to choose a path in life, because free will seems too ‘spooky’ and doesn’t fit with their strict material determinism. Where I see a universe brimming with consciousness, they see just a mass of matter, like a vast rubbish dump, a tiny portion of which suffers from the delusion of choice.

I think this is bad science, ignoring our everyday experience of being conscious and making choices. It’s bad psychology, ignoring humans’ capacity to change themselves and get out of even chronic problems like alcoholism or depression (without medication…not that there’s anything wrong with medication). And it’s bad ethics, because it empties our lives of meaning and autonomy, and leads to people like Eric wondering what’s the point of doing anything.

The hardcore materialist position also leads to the rise and rise of pharmaceutical solutions to life’s problems – people think their emotions have no meaning or connection to their own beliefs and choices, they are simply malfunctioning machines, so the only solution is to put chemicals into the machine (despite the fact that 90% or so of the effect of anti-depressants is placebo, ie it comes from our own beliefs and expectations).

This is not strictly an argument against atheism, only one variant of it. It’s also an argument against a particular variant of religion. There are religious believers who seem to have little or no belief in free will or our power to make conscious, reasonable choices in our life. We are entirely at the mercy of God’s will, and our only option is to beg God to intervene in our lives.

In Christianity, for example, there is a strong tradition going back through Calvinism and Augustine all the way to St Paul, which suggests humans have no real choice or control over whether they are ‘saved’ or not. It’s all down to God’s choice, and that choice was made before we were born.

This is why ecstatic experiences for, say, Methodists were quite so ecstatic – they felt the Holy Spirit and thought I’m saved! God had chosen me! I’m not going to Hell for eternity! Thank fuck for that! It’s like suddenly winning the lottery for eternity. As for the other 90% of humanity who aren’t chosen by God, well, sucks to be you, we’re off to Vegas, I mean, heaven!

The hardcore Calvinist belief in predestination isn’t that ubiquitous anymore, thankfully, but I still meet a lot of charismatic Christians who seem to think God has complete control over their life and they should surrender their own reason and choices entirely to God and wait for His directions. God will reveal what to do. God will show the way. God? Hello? God?!?

This also seems to me a bit of a recipe for feeling helpless and morose. The Stoic in me feels like saying, look mate, God has given you reason, and the capacity to choose your own path in life. Stop waiting for the Divine Hand to pick you out of the gutter and instead try to change those parts of your self and your life that you can (while also praying to God for help in that process).

That might sound a bit DIY – the self-help myth of the self-made man, pulling themselves up by their bootstraps. I recognize the limits of that myth. I recognize that most of my decisions are automatic, unconscious, and determined by the past and the culture I happen to be floating in, and it’s the same for others too. We don’t choose to be destructive bastards, it just sort of happens. More positively, I also recognize that there are moments of grace, moments where something beyond our rational consciousness picks us up and carries us. I am fascinated by such moments, and have been hugely helped by them in my own life.

But we can’t rely entirely on such rare moments of grace to guide us every day of our life. At least, I don’t think you can (maybe that makes me a bad Christian or a Pelagian heretic). I think part of the meaning and value of our lives comes from using our God-given free will and discernment to try and make wise decisions and to try to come closer to the reality of God. Of course, we can sometimes choose to surrender, just as the Stoics choose to surrender their external lives to the Logos. Such surrender is still, paradoxically, a choice.

You may not believe in God or the immortality of the soul. You may not believe our free will is God-given or that the proper end of it is to return to God. Still, if you believe in trying to liberate beings from suffering, and you believe we can use our reason and free will in the effort to do that, then I am on broadly on the same side as you (although of course we have some big differences). If, on the other hand, you think we have no free will and no choice, if you either think we’re entirely automatic machines or are completely at the mercy of God’s will, then to me those are two sides of the same toxic fatalism.

********

In other news:

The Harvard philosopher Roberto Unger is in London. I’ve only recently (as in…this morning) read some of his ideas. Interesting stuff – reminds me of continental philosophy like Heidegger or Badiou but the mysticism is not too pretentious and is democratic as opposed to Maoist. Read this lecture, the inspiration for his upcoming book ‘The Religion of the Future’.

Leading neuroscientist Christoph Koch explains why he believes in panpsychism – which for him means the theory that consciousness is the product of highly integrated systems, and therefore the potential for consciousness is in all matter (so the internet could become conscious, for example).

My friends at Aeon have launched Aeon Films, showcasing short, beautiful films like this one about the last days of Philip Gould, which rather undid me.

Also from Aeon, cognitive scientist of religion Jesse Bering discusses the $5 million ‘Immortality Project‘, which tries to find empirical evidence both for immortality, and our belief in immortality.

This week I spoke at a well-being at work conference to lots of Human Resources people. Weird! But interesting too – with talks from Paul Farmer of MIND about overcoming the stigma of mental illness at work; a presentation from an online CBT company called Big White Wall,and an inspiring talk by the Free Help Guy, who for six months decided to offer free anonymous help for whatever people suggested, via GumTree. This week, another anonymous person gave him £100,000 to carry on his work!

Here’s a TEDX talk I did! If you’ve seen me talk about Philosophy for Life, you’ll have heard it before. Would be great if people shared, retweeted etc.

Philosophy for Life needs all the help it can get in the US, where the publishers are struggling to get any publicity for it. Even a review on Amazon.com would help, if you feel like it.

The Nation lays into a swathe of new happiness books, declaring them ‘neoliberal’, and suggesting we should really find happiness via Keynesian economics. Which to me is another form of toxic fatalism – the only solution to our emotional problems is collectivist economics. Keynesian institutional reforms might be some of the answer but it’s not all of it – we can also take care of our own souls (and help others learn how to do that).

Finally, this week’s Start the Week had Sir John Tavener, Jeanette Winterson, and the head of All Souls College discussing prayer, faith and culture in a post-religious age. I felt like Andrew Marr was seeking to explore how his stroke had changed him and made him more interested in the life of the spirit…but there was a nervousness about doing that on primetime BBC. Interesting though, and poignant, as Tavener died the following day.

Oh, and thanks to the platinum members who contributed to the blog! Your names will echo for eternity! If you want to donate £10 or more for your annual enjoyment of the blog (it costs $30 a month to run the newsletter, not including my own time, so it’s very much a loss-making venture!), click on the link below.

]]>http://philosophyforlife.org/beware-toxic-fatalism-whether-atheist-or-theist/feed/9CBT, lost in the Moral Mazehttp://philosophyforlife.org/cbt-lost-in-the-moral-maze/
http://philosophyforlife.org/cbt-lost-in-the-moral-maze/#commentsWed, 27 Jun 2012 11:06:43 +0000http://philosophyforlife.org/?p=2204Radio 4’s Moral Maze this week looked at the government’s expansion of Cognitive Behavioural Therapy (CBT), and at a new report from Lord Richard Layard of the LSE (the principal arranger of the government’s embrace of CBT), which warns that local and national governments are failing to honour the spending commitments they made to CBT. Read more...

]]>Radio 4’s Moral Maze this week looked at the government’s expansion of Cognitive Behavioural Therapy (CBT), and at a new report from Lord Richard Layard of the LSE (the principal arranger of the government’s embrace of CBT), which warns that local and national governments are failing to honour the spending commitments they made to CBT.

I personally think that the expansion of CBT is one of the major achievements of the last five years (God knows there haven’t been that many national achievements during that time). Finally, we’re taking mental health seriously. Finally, we’ve found a therapy which works for the most common emotional disorders. And finally we’re putting in place the people and resources to enable the suffering to get help quickly. But, like most big steps forward, it’s been almost entirely un-celebrated by our media – unnoticed even – except by a few angry psychoanalysts who are indignant that CBT should have got so much funding and their own therapy so little.

So I’m disconcerted that, on one of the rare occasions that the government’s support for CBT was discussed, not one of the panellists (Michael Portillo, Matthew Taylor, Claire Fox and Melanie Phillips) should have felt the need to support it. Not one of them saw the need to defend that Service, and to try and protect its funding. What a missed opportunity. Rather than unpicking it, they should have applauded it.

Instead, the need for a National Mental Health Service was criticised from both right and left. On the right, Michael Portillo thought Richard Layard had massively over-emphasised the number of people who are affected by depression in the UK (6 million, according to David M. Clark, the psychotherapist who is the chief architect of the national CBT strategy). Portillo accused Layard of confusing depression, which is serious and nasty, with unhappiness. Lots of people are unhappy, for lots of reasons – calling it ‘depression’ just serves various ‘powerful lobbies’ (i.e. Big Pharma and the CBT industry), and gives scroungers a free ticket to benefits. If extended into the criminal justice system, it also lets people off the hook for bad deeds. Psychology becomes ‘excuseology’.

On the left, Matthew Taylor of the RSA thought Layard was medicalising unhappiness, and suggested that people might have very good social, economic and political reasons for being unhappy. CBT focuses too much on the ‘inner man’, and not enough on the outer conditions. It puts the blame for any dissatisfaction we might feel firmly on our own shoulders, which is a convenient move for government and the rich.

These concerns and confusions come about partly as a result of CBT’s origins in Greek philosophy, and I think we can clear them up if we replace CBT in its original context.

CBT emerged from Socratic and Stoic ethics, which developed as a form of ‘therapy for the soul’, which everyone could use to take care of themselves and transform their negative emotions. The idea was that you practice philosophy your whole life, both in periods of emotional turmoil (what we might call depression today) and when things are going well. The Greeks, lacking the Diagnostic Statistical Manual (DSM), did not divide emotional disorders into endless categories. They simply recognised emotional suffering – those moments when we become the passive victim of our passions, when they block us from enjoying a ‘good flow of life’. And they offered a way for students to get out of such situations, by learning how to examine their unconscious beliefs and values, and to change them.

CBT emerged from Socratic ethics, which taught people to 'take care of their souls'

As for the ‘medicalisation’ of ethics and emotions, that goes all the way back to the Greeks too. They called negative emotions ‘passions’, from the Greek pathe, meaning suffering or sickness. They often compared the philosopher to the physician, and called philosophy a ‘medical art for the soul’ (as Cicero put it). So the idea that the unhappy are also unwell is a very old one. So is the idea that the morally bad are, in fact, deluded and sick – that’s what Seneca, Plato, Marcus Aurelius and others argued. It is no easy thing to separate these categories, as the Anders Breivik case shows. Of course Breivik should be held accountable. But of course, he is also fucked up – shooting 65 teenagers is fairly strong proof of being mentally ill, to my mind.

When we go back to the ancient Greek roots of CBT, it clears up various issues.

First, the question of how much to concentrate on the inner man versus the outer conditions. We see that CBT emerged particularly from Stoic philosophy, which focuses entirely on the inner man rather than outer conditions. The philosopher, according to the Stoics, is so mentally resilient that they can be happy in any situation, even while being tortured. They make their soul an ‘inner citadel’ against their culture’s toxic values. CBT inherits this same highly individualistic focus – change your self and make it an inner citadel against the fucked-up-ness of your society.

We can (and should) disagree with this intense focus on the inner man, and point to the strong influence of environmental factors like poverty on mental health. At the same time, the Stoics were right that all humans have some capacity to control our emotions, and helping people develop this capacity gives them the strength and autonomy to change their environment and change their society.

So Stoicism / CBT doesn’t have to be some sort of neo-liberal atomised self-help. If you look at Aristotelian philosophy, for example, it shares the Socratic principles of Stoicism / CBT (i.e. the idea we can use our reason to change ourselves and achieve flourishing) but it also recognises that our society and culture plays a big part in our well-being, and that as citizens we should take care of both ourselves and our society. We should balance the inner work of CBT with the outer work of changing our society. I think Layard recognises that. He’s not saying we should focus entirely on the inner man, only that we have ignored that factor for far too long in western politics. That’s a wise realisation for a Fabian in his 70s to reach.

Secondly, the question of personal responsibility. Does CBT excuse people from their moral behaviour? Or does it put too much responsibility on our frail shoulders? Again, going back to the Greeks helps. They didn’t argue that we are all born free, rational, sovereign agents. But they argued that the vast majority of us can become slightly more free, slightly more self-aware, slightly more self-controlled, if we practice philosophy for several years. Autonomy is an exercise, and like other forms of exercise, we become better at it through practice.

But the first step is to take responsibility for our own beliefs and actions – not blame them on our environment, on our parents or friends or the economy or the weather. The economy may be terrible, and you being unemployed will almost certainly affect your mood. That’s not your fault. But how you think about your situation is going to affect your feelings. You can make that shitty situation a lot worse, if you want, or you can cope with it in a wiser and more effective way – not beating yourself up, while also looking for opportunities to get out of the situation.

Since my book has come out, I’m often asked by worried parents if their offspring’s mental / emotional problems are their fault. They are often relieved to hear about CBT, as an alternative to the old Freudian line that ‘they fuck you up your mum and dad’. Well, actually, you might very well have been fucked up by your mum and dad. They might very well have indoctrinated you in the thoughts and habits that are making you miserable today. However, these are now your thoughts and habits. Your mother and father aren’t standing over you forcing you to harm yourself. You’re doing it to yourself. As the great Bill Knaus says in my book, what happens to us is not necessarily our fault. But how we think about it is our responsibility. Don’t be a masochist. Don’t beat yourself up and then blame it on someone else.

Of course, some people are born into much harder situations than others. Some people grow up in environments that are constantly pushing them to depression or vice. Others grow up in environments that are constantly pushing them to flourish. That’s unfair, and we should do what we can to correct that. Part of that is giving people the tools to be resilient to their environment, to resist its bad influences and find the good influences.

Finally, the question of the division between Depression and unhappiness. Are we medicalising the entire society and pathologising perfectly normal things like unhappiness, shyness or anxiety? Again, let’s go back to the Greeks. Without the benefit of the Diagnostic Statistical Manual (DSM), the Greeks didn’t recognise particular emotional disorders, nor did they try to ghettoise them from ‘normal human experience’. Instead, they saw emotional suffering as on a continuum, from the very distressed to the quite distressed to the well to the flourishing. And they recognised that philosophy could and should help people all along this continuum.

Today, most people still don’t seek help for emotional problems, because they’re worried about ‘making a fuss’, or about admitting that they’re somehow officially broken or sick. Might it appear on their permanent NHS record? What if their employer found out, or their friends, or their family? Would they lose respect, authority or even their freedom as a result? And besides, isn’t it narcissistic to worry about their feelings? Who the hell is happy in this world anyway? And so most people do nothing to take care of themselves. They carry on veering through life, like a car with a flat tyre.

Philosophy, as Socrates insisted, helps us learn how to take care of ourselves. That isn’t selfish. It’s responsible. If we’re not taking care of ourselves, we’re probably affecting the people around us, and we’re also probably not engaging as effectively with our society as we could be. CBT is a form of therapeutic philosophy for people in serious distress – that could mean a particularly stressful period of your life, or a bout of depression, or panic attacks, and so on. Such moments affect many of us – perhaps 25%, perhaps as much as 50% – so go get some help, either from a GP, or from a CBT book, or from my book! Learn how to take care of yourself, how to steer yourself.

The Greeks thought philosophy should be available for everyone. I agree. I think everyone should be introduced to it, to learn how to take care of themselves. However, there is a difference to helping people in a serious emotional crisis, as CBT does, and helping people not in a serious crisis, as Positive Psychology tries to do. The latter group should not be told how to be happy. They can be taught some of the basics – how emotions arise, how we can change them – while also being encouraged to explore the different ethical visions of the good life that we can use these basics for.

One of the panellists, Michael Portillo, was particularly scornful of the fact we diagnose people with depression by asking them how they feel. People could lie, he pointed out. Well, that’s true, and no doubt many people do. But how else can we diagnose depression? How can we know how someone is feeling, except by asking them?

Aaron Beck, the pioneer of CBT, took ideas and techniques from ancient philosophy, and then married them to scientific empiricism. He invented the Beck Depression Inventory, which measures how depressed a person is by asking them, for example, how often they think about killing themselves. Now of course that sort of diagnostic technique can be fiddled by the unscrupulous. And of course, it is a bit simplistic. But it’s also a useful way of discovering if a therapy is really having any obvious effect. If a person, at the beginning of a therapy, says they’re extremely unhappy and think about killing themselves often, and at the end of the therapy they say they’re fairly happy and don’t think about killing themselves ever, then that’s a measurable success, isn’t it? And crucially, it’s only through such measurements that governments have been persuaded to support CBT. If it wasn’t for such measurements, far fewer people would be reached or helped by CBT.

I, like Portillo, am wary of the power of Big Pharma, and of a world where we have defined the entire population as in need of chemical interventions. But I do, actually, think that, in the words of Albert Ellis, 99% of the world is out of their fucking minds. Including me. We’re all on a continuum of mental health, and I certainly don’t think I am ‘flourishing’. I’m pretty well, but I’m self-aware enough to recognise I have a long way to go yet. Philosophy, no doubt, will help me on my journey.

Anyway, this is all a rather roundabout way of saying I think it is a very good thing that we now have a National Mental Health service, and that CBT has become available to ordinary people, rather than just the rich. So many of my friends have suffered from mental health problems at one time or another – most of them in quiet desperation. A lot of them could be really helped by some therapy, whether through the NHS, or through DIY therapy like reading a CBT book. That’s not narcissistic. It’s responsible. It helps them contribute to their society. Please can policy makers and opinion-influencers celebrate our new National Mental Health Service, rather than attacking it?

]]>http://philosophyforlife.org/cbt-lost-in-the-moral-maze/feed/2Should we all be popping ‘morality pills’?http://philosophyforlife.org/should-we-all-be-popping-morality-pills/
http://philosophyforlife.org/should-we-all-be-popping-morality-pills/#commentsMon, 30 Jan 2012 06:14:00 +0000http://philosophyforlife.org/?p=54Over at the New York Times’ excellent Opinionator blog, philosophers Peter Singer and Agata Sagan ponder whether we should all be prescribed ‘morality pills’ to make us more altruistic (I nicked the amusing illustration from that site as well – it’s by Leif Parsons). The authors write: Researchers at the University of Chicago recently took Read more...

Researchers at the University of Chicago recently took two rats who shared a cage and trapped one of them in a tube that could be opened only from the outside. The free rat usually tried to open the door, eventually succeeding. Even when the free rats could eat up all of a quantity of chocolate before freeing the trapped rat, they mostly preferred to free their cage-mate. The experimenters interpret their findings as demonstrating empathy in rats. But if that is the case, they have also demonstrated that individual rats vary, for only 23 of 30 rats freed their trapped companions.

The causes of the difference in their behavior must lie in the rats themselves. It seems plausible that humans, like rats, are spread along a continuum of readiness to help others. There has been considerable research on abnormal people, like psychopaths, but we need to know more about relatively stable differences (perhaps rooted in our genes) in the great majority of people as well.

Undoubtedly, situational factors can make a huge difference, and perhaps moral beliefs do as well, but if humans are just different in their predispositions to act morally, we also need to know more about these differences. Only then will we gain a proper understanding of our moral behavior, including why it varies so much from person to person and whether there is anything we can do about it.

If continuing brain research does in fact show biochemical differences between the brains of those who help others and the brains of those who do not, could this lead to a “morality pill” — a drug that makes us more likely to help? Given the many other studies linking biochemical conditions to mood and behavior, and the proliferation of drugs to modify them that have followed, the idea is not far-fetched. If so, would people choose to take it? Could criminals be given the option, as an alternative to prison, of a drug-releasing implant that would make them less likely to harm others? Might governments begin screening people to discover those most likely to commit crimes? Those who are at much greater risk of committing a crime might be offered the morality pill; if they refused, they might be required to wear a tracking device that would show where they had been at any given time, so that they would know that if they did commit a crime, they would be detected.

Fifty years ago, Anthony Burgess wrote “A Clockwork Orange,” a futuristic novel about a vicious gang leader who undergoes a procedure that makes him incapable of violence. Stanley Kubrick’s 1971 movie version sparked a discussion in which many argued that we could never be justified in depriving someone of his free will, no matter how gruesome the violence that would thereby be prevented. No doubt any proposal to develop a morality pill would encounter the same objection.

But if our brain’s chemistry does affect our moral behavior, the question of whether that balance is set in a natural way or by medical intervention will make no difference in how freely we act. If there are already biochemical differences between us that can be used to predict how ethically we will act, then either such differences are compatible with free will, or they are evidence that at least as far as some of our ethical actions are concerned, none of us have ever had free will anyway. In any case, whether or not we have free will, we may soon face new choices about the ways in which we are willing to influence behavior for the better.

One could argue, perhaps, that many of us use personality enhancers – coffee to make us work faster, wine to make us more social (a sort of morality drug). On the other hand, as a friend of mine pointed out, who decides what is moral? What if such drugs are imposed on us without our consent (as they are often imposed on people suffering from schizophrenia to make sure they fit into our socio-ethical system)? What about the case of Alan Turing, the computer genius who was chemically castrated by the British government to stop him being homosexual?

In my opinion, scientists today, and even many philosophers, are far too happy to give up on the idea of responsibility, free will, human rationality etc. When you do give up on it, it very quickly means handing over power to an elite or ‘grand controller’ to steer the automatons of the masses in the right direction. It’s amazing, and startling, how quickly that idea is becoming mainstream and respectable.

]]>I was on the Tube yesterday, and I saw an advert for something called ‘The Clear Pill’, a new drug which promised to improve your memory, cognitive skills, social skills, motor skills and basically turn you into a superhero. The small print added ‘side effects may include paralysis, paranoia and psychosis’. An intriguing ad!

Turns out it’s part of a clever viral campaign for a forthcoming film, which I think is called Limitless. Here’s another ad for it. Looks good.